Dr. Kevin Fox's specialty is family medicine. On average, patients gave him a rating of 3.5 stars out of 5. Areas of expertise for Dr. Fox include bulimia, depression, and hepatitis. Dr. Fox is affiliated with Nicklaus Children's Hospital, South Miami Hospital, and Kendall Regional Medical Center. Dr. Fox honors several insurance carriers, including Coventry, United Healthcare HSA, and United Healthcare HMO. He attended medical school at Nova Southeastern University, College of Osteopathic Medicine. He trained at Westchester General Hospital for residency. Dr. Fox speaks Spanish.

Dr. Armando Hernandez-Rey is a specialist in reproductive endocrinology and infertility. He works in Coral Gables, FL and Miami, FL. These areas are among his clinical interests: sexually transmitted diseases (STds), fibroids, and graves disease. Dr. Hernandez-Rey's patients gave him an average rating of 4.5 out of 5 stars. He honors Blue Cross/Blue Shield, Coventry, and United Healthcare HMO, as well as other insurance carriers. Dr. Hernandez-Rey graduated from the University of Medical Sciences (UCIMED) and Autonomous University of Central America. He trained at Jackson Memorial Medical Center for residency. He has received professional recognition including the following: South Florida Super Doctors. In addition to English, Dr. Hernandez-Rey (or staff) speaks Spanish and Portuguese. He is affiliated with South Miami Hospital, Mercy Hospital, and Mercy Miami Hospital.

Dr. Tessie Larrieu's specialty is general obstetrics & gynecology. Patient reviews placed her at an average of 4.0 stars out of 5. Dr. Larrieu's clinical interests encompass infertility, postmenopause, and endometriosis. She honors several insurance carriers, including Blue Cross Blue Shield EPO, Blue Cross Blue Shield Bronze, and Blue Cross Blue Shield HMO. Dr. Larrieu attended medical school at Ponce School of Medicine. She trained at a hospital affiliated with Louisiana State University for residency. She speaks Spanish. She is affiliated with South Miami Hospital, Mercy Hospital, and Mercy Miami Hospital.

Dr. Joseph Triana works as a general gynecologist. He has received a 3.0 out of 5 star rating by his patients. These areas are among Dr. Triana's clinical interests: sexually transmitted diseases (STds), incontinence, and preventive care. His hospital/clinic affiliations include South Miami Hospital, Mercy Hospital, and Mercy Miami Hospital. Dr. Triana honors Blue Cross Blue Shield EPO, Blue Cross Blue Shield Bronze, Blue Cross Blue Shield HMO, and more. His education and training includes medical school at Ponce School of Medicine and residency at a hospital affiliated with Tulane University. He speaks Spanish.

Dr. Francisco Tudela's area of specialization is general obstetrics & gynecology. His areas of expertise include multiple sclerosis (MS), osteoporosis, and preventive care. Patients gave Dr. Tudela an average rating of 4.0 stars out of 5. He accepts Blue Cross Blue Shield EPO, Blue Cross Blue Shield Bronze, and Blue Cross Blue Shield HMO, in addition to other insurance carriers. Before completing his residency at a hospital affiliated with UMDNJ-New Jersey Medical School, Dr. Tudela attended medical school at the University of Zaragoza Faculty of Medicine. He is conversant in Spanish. Dr. Tudela's professional affiliations include South Miami Hospital, Kendall Regional Medical Center, and West Kendall Baptist Hospital.

Dr. Stephanie Duncan-Garcia is a family medicine practitioner. Her clinical interests include erectile dysfunction (impotence), migraine, and depression. Dr. Duncan-Garcia's hospital/clinic affiliations include South Miami Hospital, Doctors Hospital, and Baptist Hospital. She attended Philadelphia College of Osteopathic Medicine for medical school and subsequently trained at a hospital affiliated with Nova Southeastern University for residency. Her average patient rating is 3.5 stars out of 5. She is an in-network provider for Blue Cross Blue Shield EPO, Blue Cross Blue Shield Bronze, and Blue Cross Blue Shield HMO, in addition to other insurance carriers.

Dr. Carlos Santa-Cruz is a physician who specializes in urology (urinary tract disease). He is conversant in Spanish. Clinical interests for Dr. Santa-Cruz include erectile dysfunction (impotence), incontinence, and infertility. His professional affiliations include South Miami Hospital, Doctors Hospital, and Baptist Hospital. After attending the University of Miami, Miller School of Medicine, he completed his residency training at a hospital affiliated with the University of Miami. He honors Blue Cross Blue Shield EPO, Blue Cross Blue Shield Bronze, Blue Cross Blue Shield HMO, and more.

Dr. Martin Madorsky's specialty is urology (urinary tract disease). Dr. Madorsky is rated highly by his patients. He has a special interest in erectile dysfunction (impotence), biofeedback, and incontinence. His hospital/clinic affiliations include South Miami Hospital, Doctors Hospital, and Mercy Hospital. He honors Blue Cross Blue Shield EPO, Blue Cross Blue Shield Bronze, Blue Cross Blue Shield HMO, and more. Before completing his residency at UNC Hospitals and a hospital affiliated with the University of Florida Health Science Center, Dr. Madorsky attended medical school at the University of Florida College of Medicine.

Dr. Albert Triana is a general gynecologist. Dr. Triana graduated from Ponce School of Medicine and then he performed his residency at Jackson Memorial Medical Center. His areas of expertise include sexually transmitted diseases (STds), incontinence, and infertility. Patients gave him an average rating of 4.0 stars out of 5. Dr. Triana is an in-network provider for Blue Cross Blue Shield EPO, Blue Cross Blue Shield Bronze, and Blue Cross Blue Shield HMO, in addition to other insurance carriers. He is conversant in Spanish. His professional affiliations include South Miami Hospital, Mercy Hospital, and Mercy Miami Hospital.

Currently in medical care in the United States, there are four main primary care specialties: family medicine, internal medicine, pediatrics, and geriatrics. Internal medicine is primary care for adults, pediatrics is primary care for children and infants, and geriatrics is primary care for seniors. Family medicine, the broadest specialty, is primary care for all ages.

A family medicine physician is a medical ‘home base’ for patients. They treat all ages, all sexes, all organs, and all diseases. They can see every member of the family, from birth through old age. This allows family medicine doctors to develop long-term relationships with their patients and to understand how their patients’ role in the family affects their health. They can provide check-ups, immunizations, screening services, gynecological exams and obstetric care, routine health care, and health counseling. When more specialized care is needed, a family medicine doctor can refer their patients to appropriate specialists. They can become educators and advocates for their patients in the sometimes overwhelming health care system.

As health care changes in this country, family medicine is a growing specialty for families and individuals who are seeking more personalized health care and a more personal relationship with their physician.

Psychologists are not medical doctors, but they are important workers in the mental health field. A psychologist studies the way people feel and think, as well as how thoughts and feelings change the way people act. When psychologists work with patients directly to help them feel better, they practice clinical psychology. Clinical psychologists diagnose mental health disorders and provide treatment in the form of therapy.

A clinical psychologist might work with individuals, families, groups, or organizations. They may see people who are struggling to work through difficult circumstances, trying to overcome bad habits or patterns in their lives, recovering from a brain injury, or suffering from mental illness such as depression.

Clinical psychologists are skilled assessors. Through talking to their patients they can: (1) identify which thoughts or feelings are causing the problems in their patient’s life, (2) help their patient acknowledge what emotional strengths they bring to face those problems, and (3) make plans for treatment.

Treatment varies widely depending on the patient’s problems and the psychologist’s areas of expertise. There hundreds of recognized modes of therapy; in addition, a patient may need to see a psychiatrist (medical doctor) for medication treatment. Whichever therapies a psychologist uses, the goal is to help patients see areas in their life where their thoughts or feelings are holding them back and causing distress. Through therapy, psychologists can encourage their patients to develop new ways to adapt so that they can lead happier lives.

The specialty of urology focuses on the structures of the body that produce urine and remove it from the body, such as the kidneys, ureters, bladder, and urethra. Since related structures in men are responsible for both reproduction and the transportation of urine, urologists specialize in men’s sexual health in addition to disorders of the urinary tract. Urologists treat both men and women, as well as patients ranging in age from newborn to elderly.

Certain urologic conditions are specific to male or female patients. Women are especially prone to stress incontinence, recurrent urinary tract infections, interstitial cystitis (a condition causing pain in the bladder), and urethral diverticuli (a structural issue where a small pouch develops from the urethra into the vagina). Some of these conditions may be adequately treated by a gynecologist, but patients may prefer to see a urologist because of their expertise in the urinary tract system. As for men, male infertility and sexual problems can be treated by a urologist. For example, urologists treat erectile dysfunction with medications or prosthetics. They may also perform surgeries such as vasectomies or vasectomy reversals.

Some other conditions that urologists treat include:

Kidney stones, which are mineral deposits that can form anywhere in the urinary tract. The stones can be quite painful, and some large stones may be impossible to expel naturally. Fortunately, kidney stone treatments have advanced quite a bit in recent years, and a urologist may recommend a procedure such as shockwave lithotripsy (where sound waves are used to break down the stones), or percutaneous extraction (where telescopic tools are inserted through tiny incisions in the back to remove the stones). There can be some pain associated with these treatments, but they are far less invasive than the older methods of removal.

Urinary tract infections, which are extremely common. However, if they happen over and over again, there may be an underlying problem within the urinary tract.

Congenital abnormalities, which refers to problems that are present at birth. Congenital abnormalities affect the genitourinary tract more often than any other system of the body, and they range from mild to severe in appearance and effect. The most common abnormality (in male infants) is cryptorchidism, where a testicle does not descend from the body down into the scrotum. Another common problem is hypospadias, where the opening of the urethra appears on the underside of the penis.

Renal disease, which is the loss of kidney function. For patients with renal disease, their urologist may be their primary surgeon or a coordinating member of their care team.

Tumors and malignancies, which are especially common in the case of prostate cancer. Urologists are most often consultants to oncologists in these cases.

The American Urological Association recognizes seven subspecialties of urology:

Pediatric Urology, the treatment of genitourinary tract disorders in children and infants

Urologic Oncology, the treatment of cancers within the genitourinary tract

Renal Transplantation, the treatment of severe kidney disease by replacing a non-functioning kidney with a donor kidney

Male Infertility, the treatment of infertility due to problems with sperm, semen, or male sexuality

Calculi, the treatment of kidney stones

Female Urology, the care of women’s urinary health

Neurourology, the treatment of urinary disorders caused by problems with the nervous system. For example, certain voiding disorders happen when the bladder does not receive signals appropriately, and erectile dysfunction is sometimes due to nerve loss.

Urinary and sexual problems can be especially distressing for many people. Fortunately, urologists are experts at managing these health conditions.

General obstetrician/gynecologists, or general OB/GYNs, are providers of routine care for women’s reproductive health. They offer regular checkups and preventative care to detect illnesses early and keep women healthy. A general OB/GYN cares for a variety of health issues, including:

Healthy pregnancies

Contraception

Endometriosis

Uterine fibroids

Sexually transmitted diseases

Menopause

PAP smears

Annual breast exams

After the age of 18, it is important to see a general OB/GYN regularly for preventative care as well as any needed pregnancy care. When necessary, general OB/GYNs may refer their patients to related specialists such as a Maternal-Fetal Medicine specialist or Reproductive Endocrinologist. However, women without complicated health issues may continue to see their general OB/GYN for care throughout their reproductive life.

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What is Sexual Health?

Sexual health is a broad and loosely defined term that encompasses several extremely different areas of medicine. Sexual health not only includes physical health related to the act of sex, but also emotional, mental, or identity issues that can interfere with healthy sexuality. Because this scope is so broad, a huge number of health care professionals can accurately say they work in the sexual health specialty. Some of the many varied conditions included in sexual health include intimacy disorders, sexually transmitted diseases, reproductive health, LGBTQ issues, and sexual violence.

Sexual intimacy disorders are those that cause problems with the act of sexual intercourse, such as erectile dysfunction or vulvodynia. Erectile dysfunction, the inability to get or maintain an erection hard enough for sexual intercourse, is extremely common. It affects fully half of men over 40 to some degree. It is treated with medications, devices, or surgery. Vulvodynia, burning pain in the vulva that can be made worse with sexal activity, has no known cause. It is treated with oral or topical medications.

Sexually transmitted diseases, including HIV/AIDS, herpes, gonorrhea, and chlamydia, are bacterial or viral infections that are contagious in the bodily fluids exchanged during sexual contact. Barrier methods of contraception, such as condoms, help prevent the spread of STDs. HIV is a virus that can be caught from an infected person’s sexual fluids or blood. When the virus infects the body, it interferes with the immune system and causes the disease known as AIDS. There is no cure, but anti-viral medications can help people with AIDS live a long and healthy life. Herpes is also a virus found in sexual fluids, called HSV-2. It causes blisters that come and go on the genitals. There is no cure for herpes, but anti-virals can minimize outbreaks. Gonorrhea and chlamydia are both bacterial infections. They are extremely common and often have no symptoms. The most common signs of an infection are burning pain and discharge. Gonorrhea and chlamydia can be treated with medications.

Reproductive health refers to both contraception and infertility treatment. Contraceptives prevent and plan the timing of pregnancy. Some, such as a vasectomy or tubal ligation, are extremely effective at preventing pregnancy. Others, such as spermicides, are less reliable. Popular contraceptives include condoms, birth control pills, IUDs, and diaphragms. On the other side of reproductive health, infertility is the inability to carry a pregnancy to term after one year of trying. It can be due to problems in either the man or the woman, and both genders are affected equally. In total, about 15% of the population suffer from infertility. Infertility treatments include medications and surgery.

Gay and transgender people are as healthy as anyone else, but they have a few specific health care needs that may sometimes fall under the sexual health umbrella. First, many LGBT people still face discrimination from healthcare providers, so providing supportive and appropriate care is an issue. Because of social attitudes surrounding sexual orientation and gender identity, many gay and transgender people struggle with their identities. Rates of depression, substance abuse, and suicide are all higher in this group. Providing mental health support and counseling to those in transition is critical. Finally, transgender patients who are undergoing gender affirmation require sensitive medical health care, including surgical and hormonal treatment.

Sexual violence can be defined as any unwanted or non-consensual sexual activity. It ranges from sexual harassment to touching to rape. It affects women more than men and is widespread: 1 in 4 women report being victims of sexual violence at the hands of a partner, and as many as 1 in 3 girls report their first sexual contact as being violent. Sexual violence has lasting physical and emotional consequences for victims, but educating both girls and boys can prevent violence. Care for those who have endured sexual violence includes counseling and mental health support, medical care, and legal support.

Humans are sexual creatures from the time we reach puberty through the rest of our lives. Sexuality is more than a reproductive requirement -- it is a form of expression and identity. Sexual health blends all these aspects of our experience together and helps us lead sexually fulfilling lives.